Reproductive Pearls: Pregnancy after Miscarriage
For patients, pregnancy after miscarriage can be stressful and confusing. When is the best time to get pregnant? What are the risks of recurrent miscarriage? Here, the doctors at NRM help you understand the facts about pregnancy after miscarriage.What causes miscarriage?
Miscarriage is the spontaneous loss of a pregnancy before the 20th week of gestation. It is important to know that miscarriage is most commonly not anyone’s fault. Patients worry that increased stress or activity led to their miscarriage, but consider the following:- The most common reason for miscarriage is a chromosomal abnormality in the baby (accounting for >50% of losses).
- Most of these chromosome problems occur by chance— not because of problems inherited from the parents. Such chromosome problems are unlikely to recur.
- Health conditions such as poorly controlled diabetes, thyroid disease, obesity, and some uterine abnormalities increase the risk of miscarriage.
- Smoking, other drug use and very high levels of caffeine intake (>250-300mg/ day) may increase the risk of miscarriage.
- Often, the cause of miscarriage isn't known.
What are the odds of another miscarriage?
Miscarriage is usually a one-time occurrence. Most women who miscarry go on to have healthy pregnancies after miscarriage. A small number of women— about 1 percent — will have two or more miscarriages. The predicted risk of miscarriage in a future pregnancy:- 14 % after one miscarriage
- 26 % after two miscarriages
- 28 % after three miscarriages
When is the best time for pregnancy after miscarriage?
Miscarriage can cause intense feelings of loss. You and your partner might also experience anger, sadness or guilt. At NRM, we counsel patients to take the time they need to grieve before attempting another conception.- Typically, sex is not recommended for two weeks after a miscarriage to prevent an infection.
- Your body will begin the process of growing a follicle (egg) once your BhCG level (the pregnancy hormone) returns to baseline. Therefore, it is possible to get pregnant even before your next period comes.
Consider these guidelines for timing of pregnancy after miscarriage:
- Some research has shown that women who conceived within six months of having a miscarriage in their first pregnancy had fewer complications than did those who waited longer to conceive. If you're healthy and feel ready, there might be no need to wait to conceive after miscarriage.
- If you've had two or more miscarriages, talk to an NRM provider. He or she might recommend testing to determine any underlying issues, as well as possible treatments, before attempting another pregnancy.
Is there anything that can be done to improve the chances of a healthy pregnancy?
Often, there's nothing you can do to prevent a miscarriage. However, making healthy lifestyle choices before conception and during pregnancy is important for you and your baby. Take a daily prenatal vitamin or folic acid supplement, ideally beginning a few months before conception. Maintain a healthy weight and limit caffeine. Avoid alcohol, smoking and illegal drugs.Are special tests recommended before attempting pregnancy after miscarriage?
If you experience two or more consecutive miscarriages, an NRM physician can help you understand whether further testing is needed to identify any underlying causes before attempting to get pregnant again. For example:- Blood tests. A sample of your blood is evaluated to help detect problems with hormones (thyroid hormone, blood sugar levels) or your immune system (anticardiolipin antibodies).
- Chromosomal tests. You and your partner might both have your blood tested to determine if your chromosomes are a factor. Tissue from the miscarriage — if it's available — also might be tested.
- Ultrasound. An ultrasound with saline infusion or 3D imaging might identify uterine problems such as fibroids within the uterine cavity, a birth defect in the shape of the cavity, or scar tissue.
- Hysteroscopy. Your health care provider inserts a thin, lighted instrument called a hysteroscope through your cervix into your uterus to diagnose and treat identified intrauterine problems.
